重型颅脑损伤开颅术中急性脑膨出临床分析  

Clinical analysis for acute encephalocele during severe traumatic cerebral operatoin

作　　者：周强[1] 周岱[1] 杨伊林[2] 王之敏[1] 王穗暖[2] 夏锡伟[2] 宣井岗[2] 彭亚[2] 邵耐远[2] 

机构地区：[1]苏州大学附属第一医院脑外科,215006 [2]苏州大学附属第三医院常州第一人民医院脑外科

出　　处：《中国现代医药杂志》2005年第4期12-14,共3页Modern Medicine Journal of China

摘　　要：目的探讨重型颅脑损伤开颅术中急性脑膨出的原因及有效防治措施。方法回顾性分析35例重型颅脑损伤开颅术中出现脑膨出的原因及防治措施的疗效。结果急性脑肿胀、术中迟发性颅内血肿形成、严重脑挫裂伤、长时间脑组织缺血缺氧是重型颅脑损伤开颅术中并发急性脑膨出的主要原因,本组病例死亡20例,占57.1%,存活15例,占42.9%。结论彻底清除颅内血肿,充分减压,缓慢降低颅内压,控制血压,改善脑部缺血缺氧是预防及治疗术中脑膨出的有效措施。Objective To discuss the reasons for and prophylactic therapeutic methods of acute encephalocele during severe traumatic cerebral operatoin. Methods Thirty-five severe head injured patients with acute intraoperative encephaloeele were analysed retrospectively and the preventive and treating methods were implemented. Results Acute brain swelling, delayed intracranial hematomas during operation, severe brain contussion and larceration and long-term cerebral anoxia were the main reasons for acute encephalocele during severe traumatic cerebral operatoin. Conclusion Complete hematoma evacuation, sufficient decompression, decreasing intracranial pressure gradually, maintain of systolic blood pressure and improvement of cerebral anoxia are effective methods for prevention and treatment of acute intraoDerative enceohalocele.

关 键 词：重型颅脑损伤 开颅术 急性脑膨出 重型颅脑损伤 急性脑膨出 术中 开颅 临床分析 颅内血肿形成 组织缺血缺氧 回顾性分析 急性脑肿胀 

分 类 号：R651.15[医药卫生—外科学] R719.8[医药卫生—临床医学]